Professional Documents
Culture Documents
Associate Editor
Michael G. Wyllie
Editorial Board
Ian Eardley, UK
Jean Fourcroy, USA
Sidney Glina, Brazil
Julia Heiman, USA
Chris McMahon, Australia
Bob Millar, UK
Alvaro Morales, Canada
Michael Perelman, USA
Marcel Waldinger, Netherlands
OBJECTIVE
CONCLUSION
2 0 0 5 B J U I N T E R N A T I O N A L | 9 6 , 5 9 5 5 9 7 | doi:10.1111/j.1464-410X.2005.05690.x
KEYWORDS
pelvic floor exercises, physiotherapy, erectile
dysfunction, bulbocavernosus muscle,
ischiocavernosus muscle
INTRODUCTION
Pelvic floor exercises are very effective in
treating erectile dysfunction [1,2]. The
ischiocavernosus and bulbocavernosus
muscles are superficial pelvic floor muscles
that are active during erection and which
enhance rigidity. The bulbocavernosus muscle
encircles 3350% of the base of the penis and
has three functions: it is responsible for
preventing blood from escaping during an
erection by exerting pressure on the deep
dorsal vein; it is active and pumps during
ejaculation; and it empties the bulbar urethra
by reflex action after micturition.
The aim of the present study was to examine
the role of pelvic floor muscle exercises
(focusing on the bulbocavernosus and
ischiocavernosus muscles) as a key to
restoring erectile function.
595
D O R E Y ET AL.
FIG. 1. The algorithm of the randomized controlled trial with cross-over arm.
Recruitment
(n = 56)
Randomization
(n = 55)
Baseline assessment
Intervention group (n = 28)
Intervention
3-month assessment
Intervention group (n = 25)
Home exercises
6-month assessment
Intervention group (n = 17)
Baseline assessment
Control group (n = 27)
Control
3-month assessment
Control group (n = 25)
Intervention
6-month assessment
Control group (n = 22)
Home exercises
9-month assessment
Control group (n = 16)
40
Mean erectile function domain score of the IIEF
FIG. 2.
The mean erectile function
domain scores of the IIEF for both
groups at each assessment
(baseline, open bars; 3 months,
green bars; 6 months, light green
bars; 9 months, red bars). The
green arrow shows the lifestyle
change, the red arrow the
intervention and the blue arrows
the home-exercise groups. The box
represents the interquartile range,
the central line the median, and
the bars the SD.
35
*
30
25
20
15
10
5
0
-5
-10
CONFLICT OF INTEREST
N=
17
17 17 17
16
Intervention
Sample group
16 16
Control
16
None declared.
REFERENCES
FIG. 3. A suggested algorithm for treating erectile
dysfunction.
FIRST-LINE TREATMENT
Testosterone assay
Medication review
Pelvic floor exercises
SECOND-LINE TREATMENT
Oral therapy
Vacuum devices
Constriction bands
Counselling/sex therapy
Intracavernous injections
Intra-urethral medication
Topical therapy
THIRD-LINE TREATMENT
Vascular surgery
Prosthetic implant